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Community-acquired pneumonia in patients requiring hospitalization
1Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. liamck@medicine.med.um.edu.my
Objective:
This study aimed to investigate the microbial aetiology of community-acquired pneumonia (CAP) in patients requiring hospitalization.
Methodology:
A prospective study of consecutive non-immunocompromised patients aged 12 years and above admitted with CAP from August 1997 to May 1999 was undertaken.
Results:
Of 127 patients hospitalized for CAP, an aetiological diagnosis was achieved in 53 cases (41.7%). Klebsiella pneumoniae was the most frequently isolated pathogen and caused 10.2% of all the cases, followed by Streptococcus pneumoniae (5.5%), Haemophilus influenzae (5.5%), Mycoplasma pneumoniae (3.9%) and Pseudomonas aeruginosa (3.9%). Gram-negative bacilli were significantly more frequently identified in patients aged 60 years or older and in patients with comorbid illnesses. Twelve of 13 patients who died from CAP had other comorbid illnesses compared to 63 of 114 patients who survived (P = 0.014). Three of eight bacteraemic patients died compared with 10 of 119 non-bacteraemic patients (P = 0.035).
Conclusions:
The microbiology of CAP in patients requiring hospitalization in Malaysia appears to be different from that in Western countries. Gram-negative bacilli were more frequently isolated in older patients and in those with comorbidity. Mortality from CAP is more likely in patients with comorbidity and in those who are bacteraemic.